Maximizing ‘med checks’

I commend Dr. Douglas Mossman on his balanced perspective in “Navigating the 15-minute ‘med check’” (Current Psychiatry, June 2010). Dr. Mossman was kind enough to cite my editorial¹ on the “prescriptive bond,” in which I use the term “infamous” to describe the 15-minute med check. Indeed, there are instances when a brief encounter is inadequate to address the multitude of biologic, psychological, and social issues faced by a complex patient. However, I agree with Dr. Mossman that, for some patients, a well-managed 15-minute med check may be appropriate and useful. Much depends on how well the time is structured, as Dr. Mossman’s article nicely describes. Indeed, some psychotic patients or those with extreme social phobic symptoms may not tolerate longer encounters. We must learn to do the best we can with the resources we have, while still advocating for greater access to appropriate mental health care for our patients.

Ronald Pies, MD
Professor of psychiatry
SUNY Upstate Medical University
Clinical professor of psychiatry
Tufts University School of Medicine
Boston, MA

I commend Dr. Douglas Mossman on his balanced perspective in “Navigating the 15-minute ‘med check’” (Current Psychiatry, June 2010). Dr. Mossman was kind enough to cite my editorial¹ on the “prescriptive bond,” in which I use the term “infamous” to describe the 15-minute med check. Indeed, there are instances when a brief encounter is inadequate to address the multitude of biologic, psychological, and social issues faced by a complex patient. However, I agree with Dr. Mossman that, for some patients, a well-managed 15-minute med check may be appropriate and useful. Much depends on how well the time is structured, as Dr. Mossman’s article nicely describes. Indeed, some psychotic patients or those with extreme social phobic symptoms may not tolerate longer encounters. We must learn to do the best we can with the resources we have, while still advocating for greater access to appropriate mental health care for our patients.

Ronald Pies, MD
Professor of psychiatry
SUNY Upstate Medical University
Clinical professor of psychiatry
Tufts University School of Medicine
Boston, MA

I commend Dr. Douglas Mossman on his balanced perspective in “Navigating the 15-minute ‘med check’” (Current Psychiatry, June 2010). Dr. Mossman was kind enough to cite my editorial¹ on the “prescriptive bond,” in which I use the term “infamous” to describe the 15-minute med check. Indeed, there are instances when a brief encounter is inadequate to address the multitude of biologic, psychological, and social issues faced by a complex patient. However, I agree with Dr. Mossman that, for some patients, a well-managed 15-minute med check may be appropriate and useful. Much depends on how well the time is structured, as Dr. Mossman’s article nicely describes. Indeed, some psychotic patients or those with extreme social phobic symptoms may not tolerate longer encounters. We must learn to do the best we can with the resources we have, while still advocating for greater access to appropriate mental health care for our patients.

Ronald Pies, MD
Professor of psychiatry
SUNY Upstate Medical University
Clinical professor of psychiatry
Tufts University School of Medicine
Boston, MA